This proposal stems from a longstanding collaboration between Central City Concern (CCC), an internationally-recognized community-based organization providing healthcare, housing, employment and addiction recovery support to over 13,000 inner city clients annually, Oregon Health &Science University, an academic medical center with a strong commitment to academic/community partnerships, and Portland State University, a university widely-recognized for its community engagement. The Specific Aims of this project are: 1. Using the approaches of community-based participatory research, develop a collaboration including diverse stakeholders who will co-develop research of direct relevance to the local community and to national academic and policy communities. The collaboration will include the following groups: (a) local and national academic researchers with expertise in social determinants of health, drug and alcohol addiction treatment, and community-based participatory research;(b) leaders of CCC;and (c) representatives of the communities served by CCC. 2. Create the infrastructure for research addressing social determinants of health and testing social, environmental and medical interventions for management of chronic behavioral and medical illnesses in a vulnerable population, by implementing mechanisms for rigorous primary data collection in longitudinal studies of CCC's clients and by building upon CCC's existing electronic data system in order to integrate service and outcome measures across the following domains: medical, housing, criminal behavior, addiction/recovery, mental health, and employment. 3. Ensure the sustainability of the project infrastructure through the following mechanisms: (a) integrating the project with the existing research infrastructure of OHSU's Clinical and Translational Science Institute;(b) ensuring that the data infrastructure is responsive to existing grants supporting CCC's mission;and (c) guided by the advisory committees, developing a series of research proposals that will be feasible because of the unique data available as a result of this project. PUBLIC HEALTH RELEVANCE: The partnerships and infrastructure created by this project will lay the foundation for addressing previously unanswerable questions about social determinants of health, for studying comprehensive social, environmental and medical treatments for chemical dependency, and for examining the impact of combined social and medical interventions on outcomes of other chronic diseases.